Background: Hepatitis C virus (HCV) account for a large proportion of cases of chronic liver disease, liver disease deaths, and cases of hepatocellular carcinoma (HCC), and is the predominant reason for undergoing liver transplantation. Chronic liver disease is the tenth leading cause of death among adults in the United States, causeing approximately 25,000 deaths annually; and the Centers for Disease Control and Prevention predicts that deaths due to HCV will double or triple in the next 15 to 20 years. Nurse practitioners face a rapidly changing healthcare environment. They must stay current in an environment in which medical information, technologies, and relationships with other healthcare systems are constantly in flux. A large body of literature documents the gap between scientific evidence and actual practice, underscoring the need for change in medical care. Foreground-Local Significance: According to the Arizona Department of Health Serivces (ADHS), from 1998 through 2006 there were 65,916 cases of chronic HCV infection reported in Arizona; Cochise and Pima Counties reported 881 and 9,241, respectively, for a total of 10,122 cases. ADHS receives approximately 8,000 HCV-positive reports per year. As a result, the total number of reported HCV-positive individuals in Arizona has grown to more than 80,000. ADHS estimates Arizona to have a hepatitis population of over 120,000. This equates to at least 30,000 infected individuals in Arizona who do not know about their infection. Methods-Goals, Objectives, Evaluation: The goal of this project was to facilitate empowerment of nurse practitioners to develop the knowledge, skills, and utilized practice guidelines to improve health care outcomes for patients with HCV in southern Arizona through changes in their clinical practice. The objective is improved identification by nurse practitioners of patients infected with HCV, in order to improve the management of HCV and facilitate access to specialists. The pre- and post questionnaire responses were evaluated and compared for practice change. Evidence-Based Practice Framework: A model for evidence-based practice, created by Rosswurm and Larrabee, was used to under gird this project. In the present case, the model is intended to help achieve the overarching goal of enhancing nurse practitioners’ knowledge leading to changes in practice with regards to patients with HCV. Conclusion/Recommendations: Evaluation of the effectiveness of the educational intervention involved 22 subjects over a two-month period. The results were positive with regard to practice change. Using the model for evidence-based practice led to changes in implementation of professional guidelines. To better understand individuals’ ability to sustain the changes in practice, ongoing evaluation on a quarterly or at least a semiannual basis over a two-year period of longer would be beneficial. Due to time constraints, these phases fall outside the scope of the DNP project.
